Enfermería ante el COVID-19, un punto clave para la prevención, control y mitigación de la pandemia / Nursing before COVID-19, a key point for the prevention, control and mitigation of the pandemic

Resumen El brote de SARS-CoV-2 o COVID-19 originado en China ha alcanzado a México; no obstante, la comunidad científica, entre ellas enfermería ha generado de forma vertiginosa evidencia que puede ayudar a tomar decisiones en la atención de la población afectada. El presente documento tiene la finalidad de describir la experiencia de enfermería ante el COVID-19 como un punto clave para la prevención, control y mitigación de la pandemia. Con base en las recomendaciones emitidas por la Secretaría de Salud, la evidencia clínica y los recursos disponibles en las instituciones de salud se ha iniciado y mantenido las medidas de prevención de la enfermedad tanto en la comunidad como en las instituciones de salud. La reconversión de los hospitales y los protocolos de atención adaptados a nuestro contexto están tratando de fortalecer el control y mitigación de la enfermedad.

Abstract The SARS-CoV-2 or COVID-19 outbreak originated in China has reached Mexico. However, the scientific community, including nursing, has generated vertiginous evidence that can help make decisions in the care of the affected population. The purpose of this study is to describe the nursing experience before COVID-19 as a key point for the prevention, control and mitigation of the pandemic. Based on the recommendations issued by the Ministry of Health, the clinical evidence and the resources available in the health institutions, the disease prevention measures have been initiated and maintained both in the community and in the health institutions. The reconversion of hospitals and care protocols adapted to our context are trying to strengthen the control and mitigation of the disease.

Utilidad del catéter Tenckhoff en el postoperatorio de cirugía cardiaca pediátrica / Utility of Tenckhoff catheter in the pediatric cardiac post-surgery period

Introducción: El catéter de Tenckhoff generalmente se utiliza en el procedimiento de diálisis peritoneal, su empleo se ha observado en la terapia intensiva postquirúrgica en pacientes pediátricos postoperados de corazón, sin embargo se carece de información documentada acerca de las indicaciones de la instalación del catéter de Tenckhoff y su utilidad en este grupo de pacientes. Objetivo: Identificar la frecuencia de indicación y la utilidad del catéter de Tenckhoff en el postoperatorio de cirugía cardiaca en pacientes pediátricos. Metodología: Se efectuó la revisión de 537 expedientes clínicos de pacientes pediátricos postoperados de cirugía cardiaca durante un año para analizar en forma retrospectiva la indicación y utilidad de la instalación del catéter de Tenckhoff. Resultados: Se instaló catéter de Tenckhoff en 9.1% de los pacientes (49 de 537). La muestra estuvo integrada por 49 expedientes siendo la indicación más frecuente ascitis 60.5%, seguido por edema agudo pulmonar 19%, sobrecarga hídrica 6%, acidosis metabólica 2% y oligoanuria 12.5%. La utilidad del catéter de Tenckhoff fue para drenaje de líquido de ascitis, 60.5%, 27% para diálisis aguda y 12% para diálisis con permanencia de líquido en cavidad peritoneal. Discusión: El catéter de Teckhoff en la unidad de terapia intensiva postquirúrgica está frecuentemente indicado en el caso de ascitis y la principal utilidad es el drenaje de líquido, sin descartar su uso en el procedimiento de diálisis peritoneal.

Introduction: Generally, Tenckhoff catheter is used for the dialysis peritoneal procedure. Its use has been observed in the intensive post-surgical care unit in pediatric patients with heart post-surgery; however, there is a scarcity of documented information regarding the indications of Tenckhoff catheter insertion and its utility in this kind of patients. Objective: To identify the frequency of insertion and the utility of Tenckhoff catheter in the post-surgical period in patients with cardiac surgery. Methodology: A review of 537 clinical charts of pediatric patients who were in post-surgery cardiac period was done during a year to analyze retrospectively the basis of indication and the utility of Tenckhoff catheter insertion. Results: A Tenckhoff catheter was inserted in 9.1% of the studied patients (49 out of 537). The sample was made by 49 clinical charts; the most frequent indication was ascitis 60.5%, followed by pulmonary acute edema 19%, hydric overload 6%, metabolic acidosis 2%, and oligoanuria 12.5%. The utility of Tenckhoff catheter was 60.5% to drainage of ascitis fluid, 27% for acute dialysis, and 12% for dialysis with permanency of fluids in the peritoneal cavity. Discussion: In the intensive postsurgical care unit, the Tenckhoff catheter is often indicated in case of ascitis, and it is mainly useful to drain fluid, without shun its use for peritoneal dialysis procedure.

Tratamiento farmacológico de los síndromes isquémicos coronarios agudos / Pharmacologic treatment of the ischaemic syndromes

The term acute coronary syndromes includes a phantom of symptomatic clinical pictures that represent the acute occlusion of the coronary arteries by diverse degrees of plate of cholesterol, clot and spasm. They are divided in acute coronary ischemic syndromes without elevation of the ST (instable angina). And with elevation of the ST (acute infarct to the myocardium). The pharmacologic therapy includes a treatment in common for the syndromes before diagnosing the tipe of syndrome, this called therapy attached treatment includes the administration of oxygen, morphine, aspirin, nitrates, betablock, astatines and laxatives. The treatment for the acute coronary ischemic syndromes without elevation of the ST is with a preservative strategy where plaquetary antithrombotic drugs are used, while in the treatment of the acute coronary ischemic syndromes with elevation of the ST the strategy is of repercussion with the fibrinolytic drugs use like streptokinase anda rt-PA. The participation of infirmary is essential during the evolution and treatment of the individual dividing in four sections its interventions according to the clinical situation and time of intervention.